The New York Columbia Collaborative Specialized Program on Translational Research In Acute Stroke will involve key personnel from Columbia University and the NY Presbyterian Hospital. The overall goals are to enhance the delivery of acute stroke patient care with a focus on a high-risk disadvantaged population, train acute stroke translational researchers, and conduct 3 innovative acute stroke projects. The projects share subjects identified through the patient access core, and utilize blood and data management and statistics cores. Project 1 is a dose-escalation and pilot clinical trial to evaluate the effects of short-term early use of high-dose simvastatin therapy (Neu-START: Neuroprotection with Statin Therapy for Acute Recovery Trial). Simvastatin has been shown in rodent stroke models to reduce neuronal injury and infarct size primarily related to improving vascular flow and function rather than on a direct neuronal cytoprotective benefit. This translational project will randomize 60 acute strokes within 12 hours for phase IB and 90 within 6 hours for phase IIA and evaluate safety and surrogate measures of systemic inflammatory markers. Project 2 (Brain Plasticity in Acute Stroke: a Functional MRI Study) will investigate the unexplained variability in early stroke outcomes by evaluating the role of brain plasticity in the acute time period. To determine the network of contralesional brain regions after acute stroke that predicts good stroke recovery at 1 week and 3 months, we will recruit 100 acute stroke patients, and obtain fMRI scans at 24 to 48 hours. Project 3 (SWIFT: Stroke Warning Information and Faster Treatment) will be aimed at decreasing the delay in presentation of acute stroke patients to the hospital from a disadvantaged population. To evaluate the efficacy of a culturally sensitive, targeted educational/behavioral modification program performed over three interactive sessions, we will randomize 1400 strokeATIA survivors and 1200 community subjects and assess changes in stroke knowledge and behavior, as well as improvement in time to arrival to the ED.